Examination of Witnesses (Questions 280
TUESDAY 23 APRIL 2002
280. The Audit Commission is not going to be
around until 2004.
(Mr Macpherson) Absolutely. At the moment we have
the CHI and we also have the Audit Commission. We will certainly
encourage them to continue to work very diligently in the meantime
to get the sort of data which we need to hold people to account.
281. How can we be kept informed of the progress
in spending this money?
(Mr Macpherson) I think you will be kept informed
both through the work of the National Audit Office, through the
Audit Commission and the Commission for Health Improvement.
282. I do not mean in three years' time, I mean
in three months' time.
(Mr Macpherson) Regular figures will be produced.
The Department of Health produce regular reports. The Chief Executive,
Nigel Crisp, only a month ago produced a very useful document
setting out how the Health Department was doing against its targets.
283. Can I ask the reverse of Mr Beard's question.
If you are devolving all this money to primary care trusts and
giving more freedom to three star trusts and strategic health
authorities and so on to incentivise people, how do you stop this
money leaking out into higher awards for management and performance
bonuses and more salaries all round for senior managers? I can
see how you control the bulk of staff through the review bodies
but how can you ensure (the great public fear) that this does
not go into more bureaucracy locally? How do you ensure that does
(Mr Macpherson) I think, as I say, in terms of local
level, the strategic health authorities are going to play a key
role but ultimately what matters is whether these trusts deliver
their targets. Certainly we are not against incentivising managers
so long as the incentives are tightly drawn, and rigorous. If
those public sector managers are then incentivised to really deliver,
sort out things like waiting times, it is perfectly reasonable
to pay them a decent performance bonus, but if not, not. One of
the very clear things with this star system is if you are a useless
trust manager you will get found out very quickly and in many
cases you will be lucky if you hang on to your job. It is a far
more dynamic system.
284. That is a big departure. Mr Beard made
the point of being kept informed regularly. He was thinking of
every three months or so but is there an opportunity to keep us
informed on a quarterly basis?
(Mr Macpherson) At the moment my understanding is
that the Department of Health will report on progress in its annual
report both in the spring and as we move to the new resource accounting
system in the autumn as well, which is at least twice a year.
In addition, as with Nigel Crisp's report last month, my guess
is there will be further opportunities to hold Alan Milburn and
Nigel Crisp to account on progress.
Chairman: If you could bear our comments
in mind and perhaps report back what you find. That was very interesting,
we thank you for your attendance this morning. I am sorry we did
not come on to productivity, Mr Kingman, but we will get the chance
to engage in that subject tomorrow by asking the Chancellor direct
on productivity without your intervention. Thank you very much.